Testing a Couple-based Program for Alcohol Risk Reduction in the National Guard

在国民警卫队中测试以夫妻为基础的降低酒精风险计划

• 批准号: 9037563
• 负责人: Elizabeth Ellen Epstein
• 金额: $ 25.01万
• 依托单位: UNIV OF MASSACHUSETTS MED SCH WORCESTER
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-03-20 至 2018-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9037563
• 关键词: Address; Alcohol consumption; Alcohols; Attitude; Behavioral; Belief; Caring; Collaborations; Complex; Conflict (Psychology); Coping Skills; Couples; Couples Therapy; Depression and Suicide; Ensure; Family; Freedom; Funding; Goals; Health; Health Promotion; Health Services Research; Heavy Drinking; Human Resources; Institute of Medicine (U.S.); Internet; Intervention; Learning; Manuals; Massachusetts; Measures; Mediator of activation protein; Mental Health; Military Personnel; Monitor; Outcome; Personal Satisfaction; Persons; Pharmaceutical Preparations; Population; Prevention; Prevention Protocols; Prevention approach; Prevention program; Prevention strategy; Preventive Intervention; Problem Solving; Protocols documentation; Public Health; Randomized Controlled Trials; Readiness; Recommendation; Relapse; Research; Research Project Grants; Risk; Risk Factors; Risk Reduction; Secondary Prevention; Services; Spouses; Staging; Support System; Symptoms; System; Testing; United States National Institutes of Health; Work; alcohol misuse; alcohol risk reduction; alcohol use disorder; analog; arm; base; behavior change; binge drinking; cohort; design; drinking; drinking behavior; evidence base; field study; fitness; hazardous drinking; healthy lifestyle; high risk drinking; indicated prevention; learning materials; member; operation; primary outcome; programs; protocol development; psychologic; public health relevance; resilience; response; secondary outcome; stem; telehealth; uptake; use alcohol to cope

DESCRIPTION (provided by applicant): Rates of binge drinking in the military currently hover at 47% and constitute a "public health crisis" (IOM, 2012), with few evidence-based prevention programs in place to stem the tide. Hazardous drinking among service members is directly detrimental to psychological fitness and military readiness, and is also a risk factor for several overlapping problems, including alcohol use disorder (AUD), use of other drugs, depression, suicide, and relationship conflict. This R34, "Testing A Couple-based Program for Alcohol Risk Reduction in the National Guard," in line with PAR-12-279, aims to develop and test an indicated, secondary prevention intervention to harness marital support and health promoting endeavors such as relationship enhancement and problem solving to replace use of alcohol to cope with reintegration challenges. Up to 81% of military members are married or in a committed relationship and the integration of couple-based prevention programs into military service settings has been identified as a promising but underutilized health promotion strategy. National Guard (NG) members and their families are a special needs population due to high rates of heavy drinking, mental health, and family problems, paired with geographic challenges that limit access to military heath care support systems. The proposed "indicated secondary prevention" project targets hazardous drinking NG members who have not yet developed AUD. Aim 1 is to modify our efficacious Alcohol Behavioral Couple Therapy (ABCT) manual into a brief indicated secondary prevention protocol called Alcohol Behavioral Couple Prevention (ABCP), available for in-person or telehealth delivery by professionals or paraprofessionals in military settings. The goal of the new ABCP is for couples to learn to work together to minimize hazardous drinking in order to then begin to effectively address other problems often present among returning service members. Aim 2 is to field test an in-person delivery platform of the protocol (ABCP_P) with 6 couples, refine, and then field test a telehealth delivery platform (ABCP_T) for the refined protocol with 6 new couples. Aim 3 is to conduct a small randomized controlled trial with 22 couples in each condition: (1) "Prevention as usual" (PAU) which includes annual briefings and a limited monitoring system currently in place in the NG; (2) PAU plus ABCP_P, and (3) PAU plus ABCP_T. Primary outcome variables include alcohol use, marital functioning and coping skills. Candidate mediators of health promotion behavior change, including attitudes and beliefs about drinking will be tracked. This project is in accord with IOM (2013) recommendations; it aims to fill a gap in prevention strategies for hazardous drinking and associated risks among service members, with an evidence-based risk reduction protocol to support overall force readiness while strengthening the family unit. Further, it includes a teleheath delivery platform to address geographic challenges and lower barriers to accessible services for the armed forces.

描述（由申请人提供）：目前悬停在47％的军事中的暴饮暴食率，构成“公共卫生危机”（IOM，2012年），几乎没有循证预防计划来阻止潮汐。服务成员之间的危险饮酒直接不利于心理健康和军事准备，也是几个重叠问题的危险因素，包括酒精使用障碍（AUD），其他药物，抑郁症，自杀和关系冲突。这款R34“测试基于夫妇的国民警卫队降低酒精风险计划”，旨在开发和测试一种指示的，二级预防干预措施，以利用婚姻支持和健康促进健康的努力，例如增强关系增强和解决问题，以替代酒精以应对重新融合挑战。多达81％的军事成员已婚或建立了坚定的关系，并且将基于夫妇的预防计划融入军事服务环境中已被确定为一种有前途但未充分利用的健康促进策略。国民警卫队（NG）的成员及其家人是特殊需求人群，这是由于饮酒，心理健康和家庭问题的高率，再加上地理挑战，这些挑战限制了获得军事健康护理支持系统的机会。拟议的“指示二级预防”项目针对尚未开发出AUD的危险饮酒成员。 AIM 1是将我们有效的酒精行为夫妇疗法（ABCT）修改为简短的二级预防协议，称为酒精行为夫妇预防（ABCP），可用于军事环境中的专业人员或专业人士的面对面或远程医疗保健。新的ABCP的目标是让夫妻学习一起工作以最大程度地减少危险饮酒，然后开始有效解决返回服务成员之间经常存在的其他问题。 AIM 2是要现场测试与6对夫妻的协议（ABCP_P）的面对面交付平台，完善的，然后对远程医疗传递平台（ABCP_T）进行现场测试，用于与6对新夫妇进行精制协议。 AIM 3是在每种情况下进行22对夫妇进行小型随机对照试验：（1）“像往常一样预防”（PAU），其中包括年度简报和NG目前已有的有限监测系统； （2）PAU加ABCP_P，（3）PAU加ABCP_T。主要结果变量包括饮酒，婚姻功能和应对能力。将跟踪健康促进行为行为改变的候选人，包括对饮酒的态度和信念。该项目符合IOM（2013）建议；它的目的是填补服务成员中危险饮酒和相关风险的预防策略的空白，并采用基于证据的风险降低协议，以支持整体力量准备，同时加强家庭单位。此外，它包括一个电信交付平台，以应对地理挑战和较低的武装部队服务障碍。